Wednesday 2 December 2020

Can a girl be mistaken that she is a boy?


The High Court has recently ruled that children under sixteen are unlikely to be able to give informed consent to puberty blocking treatment. There are of course lots of treatments that under sixteens cannot understand. There are illnesses and treatments indeed that adults struggle to understand. Faced with a serious illness no one can know exactly what the result of treatment will be not even the doctors. What then should be so problematic about puberty blocking?

The High Court is making the issue one of age, but it is hard to see any major differences between the thought processes of a fifteen-year-old and a twenty-five-year-old. School children have to make life changing decisions when they choose which subjects to study at school. A decision to concentrate on playing football may lead a twelve-year-old to a job where he earns thousands a week or alternatively to unemployment, but we allow him to make it. What is so particularly problematic about the decision to take puberty blockers?

The reason the case came to the High Court at all is that Keira Bell believed during her teens that she was a boy. She went to Tavistock and Portman NHS Trust sought advice and treatment. She was prescribed puberty blockers and later male hormones. She had surgery to remove her breasts. After all this she decided that she was not after all a man and wanted to revert to being a woman.

The problem with puberty blockers is that they can only be prescribed to children and in some cases the effects of taking such drugs is permanent. If a girl takes puberty blockers, she may be infertile. If she takes testosterone she may be left with permanent physical changes to her voice, her hair and her body. If she has parts of her body such as breasts removed, they can no more be replaced than if she had a leg removed. If she decides to have surgery on her genitals, it may not be possible to reverse this process.

The reason such treatment was problematic in Keira Bell’s case was fundamentally not because she was too young to make the decision, but that she changed her mind. If she had been happy with her male identity there would have been no need to worry when she had the puberty blockers.

Keira Bell did not have an illness like cancer, where there was no real alternative to treatment. Her treatment was not because she was in a conventional sense ill at all. Doctors looking at her body would have found nothing malfunctioning and no illness that would lead to death if untreated. If there was an illness it was psychological.

But this is our problem. We normally treat psychological problems with therapy and drugs. We don’t treat them with surgery anymore. Indeed, cutting out bits of people’s brains because of psychological problems is considered barbaric today. Why then do we treat the problem that Keira Bell had by hormones and mutilation of otherwise healthy body parts?

What is it for someone to believe that they are a boy? Keira Bell believed she was a boy and sought treatment with puberty blockers. She now believes that she was mistaken. But how do we discover the truth of her belief?

In recognising the problem of someone changing their mind, the High Court has implicitly said that someone who sincerely believes he is a girl can be mistaken. It is for this reason that he cannot consent to the treatment. But what can this mistake consist in?

One hundred years ago if Keira Bell had gone to a doctor and seriously claimed that she was a boy, the doctor would have examined her and would have told her, I’m sorry but you are mistaken. You are a girl because you have a female body. It is not possible to change this. This is how you were born, and this is how you will remain.

But now what is it that makes someone a girl or a boy. How do we distinguish between the one and the other? If a girl’s belief that she is a boy is enough to justify puberty blockers though this belief contradicts her having a female body, then how can it be that she could later be mistaken? To suppose that Keira Bell was mistaken about her being a boy is to suppose that there is a truth that she really was a girl and really is a woman, based not merely on how she feels or what she believes, but about what she actually is.

To suppose that it is problematic to give children puberty blockers is to suppose that a girl might make a mistake in supposing that she is a boy. But to suppose this is to suppose that there is a way of objectively determining that someone is a girl and a boy otherwise there can be no question of making a mistake and likewise no question of regret.

If it were true that Keira Bell now really is a man then there would be no reason for her to regret the treatment which attempted to change her body from that of a girl to that of a boy. The problem is that Keira Bell thought she was a boy, but really was a girl. If that is not the case the High Court has no reason to prevent children receiving puberty blockers.

But once we accept that there is a reality to someone being a boy or a girl and that this is determined objectively, the justification for transgender treatment like puberty blockers collapses. The problem of transgender becomes a problem of mind requiring the person to accept the reality of what he is, rather than a problem of body requiring parts to be added or subtracted.

Once we accept that a girl can be mistaken about being a boy, then logically we must realise that a man can be mistaken when he thinks that he is a woman. But how are we to discover the truth? We cannot look into people’s minds and anyway if a mind can be mistaken about whether it belongs to a man or a woman, we are not going to find the answer there. How can we adjudicate the mistake?

The only answer is to accept that being a man or a woman has nothing whatsoever to do with someone’s mind. We adjudicate who is a boy and who is a girl by the body of each. Once we accept this then the problem of transgender dissolves. Doctors must simply tell adults and children that there is no such thing as transgender. They can mutilate their bodies as much as they please. They can pump themselves with male or female hormones. They can have male or female genital mutilation. But none of these things will change what they are.

Once people learn that there really is no changing who they are there is the first stage of accepting it. At this point it may be possible to develop therapies that alleviate the problem. But having a true and realistic belief is the foundation of all psychological wellbeing.

The High Court has destroyed the intellectual foundation of Transgenderism. Once you accept that Keira Bell thought she was a boy, but she was mistaken, then the idea that being a girl or a boy is a matter of belief collapses. It is a matter of reality.

At some point in the future Transgenderism will be looked on like phrenology except that phrenology despite being mere pseudoscience and quackery was more plausible.